# CENTRAL MISSISSIPPI PREVENTION SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942478144
- **Authorized official:** JOSEPH DANIEL JOHNSON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (601) 631-0102

## Contact information

- **Practice address:** 1911 MISSION 66 STE B, VICKSBURG, MS 39180-3762
- **Practice address phone:** (601) 631-0102
- **Practice address fax:** (601) 631-0131
- **Mailing address:** 1911 MISSION 66 STE B, VICKSBURG, MS 39180-3762
- **Mailing address phone:** (601) 631-0102
- **Mailing address fax:** (601) 631-0131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | C1126 | MS | Yes |

## Other

- **Enumeration date:** 02/11/2008
- **Last updated:** 02/11/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00535256 | — | MS |